Irritable Bowel Syndrome (IBS): Causes, triggers and management

Talking about it isn’t easy. You have real symptoms — including cramps, bloating and diarrhea. You know by now that it’s not all “in your head,” but it’s also not all in your gut — you’re aware of the mind-body connection. Realizing you might be dealing with a cluster of problems with many causes is the first step in helping you tackle irritable bowel syndrome (IBS) from all fronts.

So, where do you start?

Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine (colon). IBS can cause cramping, bloating, gas, diarrhea and constipation. It doesn’t go away on its own — it’s a chronic condition that you manage over the long term.

It’s possible to control symptoms by managing diet, lifestyle and stress. Other options include medication and counseling. Because it arises from many causes, there are many approaches to managing IBS. You can count on a slightly different approach from your friend with IBS, because it will depend on your individual triggers. The important thing is there are ways to manage IBS and reclaim control of your life.

Chances are you know someone with IBS, whether they are open or discreet about it. The U.S. Department of Health and Human Services says that up to one in five Americans has IBS and 75 percent of them are women.

Irritable bowel syndrome means that not only is the bowel irritated, but a whole constellation of symptoms and causes is involved in IBS. Unlike inflammatory bowel disease (IBD, Crohn’s and ulcerative colitis — diseases that can increase your risk of colorectal cancer), researchers haven’t discovered traceable evidence of IBS in the bowel, so a definition has yet to be developed. Thus, IBS remains an umbrella term encompassing bowel dysfunction that can play out in many ways and for many reasons.

Here are some symptoms frequently associated with IBS:

Altered bowel patterns

Constipation

Pain with bowel movements

Painless diarrhea

Alternating constipation and diarrhea

Flatulence

Nausea

Vomiting

Headaches

Loss of appetite

Early satiety

Anxiety

Depression

Poor nutrient absorption

Bloating

Although we don’t know the exact cause, these are common IBS triggers:

Gut bacteria. If you take an antibiotics repeatedly, they can wipe out bacteria in your gut — good and bad. Once the friendly bacteria that help digest your food and protect the gut lining become imbalanced, digestive capabilities are compromised, increasing your tendency to develop IBS.

An infection. You can develop IBS after contracting a case of food poisoning or any intestinal parasite.

Food sensitivities/intolerances. Some of the most common food triggers are wheat, gluten, dairy, corn, sugar, chocolate, coffee, tea and citrus fruits.

Hormonal imbalance. Many women notice that their IBS symptoms worsen just before their periods. This might be related to the pattern of hormonal fluctuation in the second half of the cycle: estrogen is lower for several days, whereas progesterone is relatively high at the end of the cycle, then drops off suddenly just before menses. Progesterone slows gut motility, and lower-than-normal estrogen levels have been identified in women with IBS. It’s possible that when the ratio between these two sex hormones is off, sluggish bowels could worsen cramping and bloating.

Stress and anxiety. When we’re stressed, changes occur in the autonomic nervous system — the system of nerves that make up the sympathetic (governs our “fight or flight” responses) and parasympathetic (regulates the “rest and digest” responses) nervous systems. In IBS, input from the brain sends a message to decrease digestion and increase motility of the colon, causing cramping and diarrhea.

As you learn more about IBS, try to keep a log to help you identify things that seem to make your symptoms worse. Then, find a doctor who will work with you over the long term to help you manage and treat your IBS.

Remember that meds only treat a specific symptom. Your doctor might start by addressing your most disruptive symptom, but other symptoms might have to be managed with diet and stress management.

Food is just one aspect of IBS, and you’ll notice that one food is okay one day, but not okay the next. This is where a log detailing foods, times, level of stress and bathroom patterns can help you identify triggers — or a combination of triggers. You might find that you can enjoy a type of food you like when other triggers such as stress are under control.

In some cases, IBS is more about your body’s reaction to food than about the food itself. You can live a full life by managing IBS day by day.